Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes
Minguell-Monyart, Joan (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Moreira Borim, Felipe (Universitat Autònoma de Barcelona. Departament de Ciències Morfològiques)
Revertè Vinaixa, Maria Mercedes (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Portas-Torres, Irene (Hospital Universitari Vall d'Hebron)
Pijoan Bueno, Joan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castellet Feliu, Enric (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Joshi Jubert, Nayana (Universitat Autònoma de Barcelona. Departament de Cirurgia)

Date:	2023
Abstract:	Purpose: Multiple studies have shown higher failure rate and patient-reported outcomes to be significantly worse following revision anterior cruciate ligament reconstructive (ACLR) surgery, especially using allografts. One of the reasons being rotational instability. Because of this, augmentation with lateral extra-articular tenodesis (LET) is often considered. Good short-term results in regards to functional and perceived scores and low complication rate can be expected in revision ACLR using allografts in combination with LET. Methods: Between 2014 and 2021, 46 patients were registered for revision ACLR using allografts and extra-articular augmentation (modified Lemaire) and included in this prospective study. Patients' demographic and clinical data were collected preoperatively, postoperatively, and during the follow-up period of 12 months. Results: Patient-reported functional outcomes were statistically significant for IKDC, Lysholm, and SF-12 physical scale (p < 0. 05). Tegner score showed a decreased number of patients who were able to return to sport at their previous level (p = 0. 001). Stability examination tests (Lachman and pivot-shift) showed significant improvements. Concomitant lesions were present in 76. 1% of patients. Ten patients (21. 7%) presented major complications, including six cases of anteroposterior instability, three cases of knee pain and one graft re-rupture. Conclusion: Revision procedures are inherently challenging with a high number of associated chondral and meniscus lesions. However, good short-term functional outcomes and enhanced rotational stability with an acceptable complication rate can be expected in most cases where revision ACLR using allografts is augmented with LET.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	European journal of orthopaedic surgery & traumatology, 2023 , ISSN 1432-1068

DOI: 10.1007/s00590-023-03475-4
PMID: 36708388

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